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1. Dr. Bouchard, what is the temperature threshold when we should be starting tick prevention strategies?

The commonly cited temperature threshold for adult blacklegged ticks is 4^oC. However, ticks may not always be active at this temperature, and they can be active in warmer microenvironments even when the ambient temperature is below 4^oC.

As a general rule, tick prevention and administration of tick control products should begin when snow starts to melt and continue until at least one to two weeks after snow cover returns. However, this varies across regions in Canada and can be hard to predict. Temperature matters, especially in areas without consistent snow cover, but tick activity also depends on other environmental factors such as day length/photoperiod.

Given Canada’s variable climate and the growing risk of tick-borne diseases, year-round awareness is key. This includes avoiding tick habitats, performing regular tick checks on animals and people, and removing ticks promptly as daily practice.

2. Dr. Bouchard, is adult blacklegged tick activity similar to that of the immature stages?

Adult and nymphal stages of blacklegged ticks can both transmit Borrelia burgdorferi, the bacteria that causes Lyme disease. Larvae do not transmit the bacteria because they must first acquire it during their first bloodmeal.

The immature stages of blacklegged ticks have different peak activity periods compared to the adult blacklegged tick. The nymphs have peak questing activity in spring and the larvae in the summer. Adults are typically most active in the fall, but a second lesser peak of activity is seen in spring. In some parts of southern Canada, adult ticks may remain active in winter months in the absence of snow cover and if environmental conditions are appropriate for them to be active.

3. Dr. Bouchard, how long does Anaplasma phagocytophilum need to get transferred after the tick starts to feed?

Studies in animal models suggest that Anaplasma phagocytophilum (similar to the bacteria that cause Lyme disease), is more likely to be transmitted the longer an infected tick is attached. However, unlike Lyme disease, research shows that A. phagocytophilum can be transmitted by a single infected nymph in as little as 24 hours after attachment.

4. Dr. Coe, how can clinics leverage the Value Matrix concept at the clinic level when speaking to pet owners about tick control?

My first suggestion for clinics to leverage the Value Matrix is to use it as an exercise for the entire practice (or at least those having client-facing conversations with clients about tick protection) to participate in. Having the entire team develop a Value Matrix together (or if a larger clinic break into groups of four or five, and each group create a Value Matrix and then compare) allows for a clinic-wide discussion around options relating to tick protection as well as the benefits associated with each option – this helps create a consistent practice level message. 

My second suggestion is to use the Value Matrix to help each team member organize their thoughts around how they can present clients with options on tick protection including the key messages on what each option provides in terms of benefits for a client and, importantly, their pet.  By using the Value Matrix to organize one's thinking about how to present information, the presentation of options is likely to be more structured and easier to deliver for the veterinary professional and, in turn, easier to follow and understand for the client. 

My third suggestion is to consider whether there is a benefit in using the Value Matrix as a visual aid with clients to further assist their understanding and recall of information about tick protection strategies – ideally this would be something created with the client – taking into consideration things learned from them by gathering a comprehensive history in order to tailor the Value Matrix/presentation of options to each individual client, patient, and their situation.

5. Dr. Coe, pet owners are expecting a recommendation from their veterinarian. How is providing options to the pet owner beneficial?

Our research has consistently shown that most clients want options, and they want to be involved in healthcare decisions for their pet alongside their veterinarian.^{5, 6, 7} Our research also suggests that when veterinarians lead with their recommendation, and do not first learn about the client or involve the client in the decision-making process, clients can become defensive or suspicious of what is driving the veterinarian's recommendation. By presenting clients options, including the benefit (or lack thereof) of each option for their animal and engaging clients in the decision-making process, we preserve a client's autonomy as well as reduce their potential suspicion by allowing the client to understand the benefit of each option to their situation and their animal's health and well-being.   

This also better positions the veterinarian to make a recommendation that carries relevance to the client, their animal, and their situation. As much as we consistently hear in our research that clients want to be presented with options and want to be engaged in decision-making, we also hear that they are looking for guidance and support from their veterinarian (i.e., a recommendation) that takes into consideration their perspective, their animal, and their situation. Providing options does not preclude a veterinarian from providing a recommendation, rather it is making clients aware that there are options and then tailoring a recommendation that takes into consideration the respective client, pet and their situation. To quote a pet owner in one of our focus group studies: "To have a straight up conversation about the range of options, the professional advice from the vet’s view, the preferred option to the circumstance. I think that’s part of the service and I still get to exercise choice."⁷